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Health & Welfare Plans Newsletter

October 5, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

Exceptional Usefulness and Quality icon A Plan Sponsor's Q&A Guide to Understanding and Implementing MHPAEA (PDF)

17 pages. "In general, what must a health plan assure to be compliant with MHPAEA's requirements? ... Are there specific NQTLs that the Departments intend to focus on when requesting comparative analyses from plans and issuers for purposes of review in accordance with the requirements of the CAA? ... How do I show my benefit plan meets the requirements of MHPAEA? ... What are examples of reasons why the Departments might conclude that documentation of comparative analyses of NQTLs is insufficiently specific and detailed? ... What information must be made available to the members of the plan? ... Are there any penalties associated with failing to achieve MHPAEA's substantive compliance requirements?"  MORE >>

Baldwin Risk Partners

[Guidance Overview]

Agencies Press Play on Prescription Drug Machine-Readable File Requirement

"Subject to the implementation timeline set to be announced by the Departments in future guidance, plan sponsors will need to work with service providers to put together a game plan to gather the required information and post the prescription drug machine-readable file. Plan sponsors currently relying on the enforcement safe harbor with respect to the requirement to list in-network rates as dollar amounts for items and service covered by arrangements that make it difficult to express the cost as a dollar amount will need to swiftly assess whether any changes are needed in light of the rescission of the safe harbor."  MORE >>


[Guidance Overview]

Agencies Signal More Healthcare Coverage Mandates

"Current agency guidance interpreting statutory and regulatory requirements states that preventive products that are generally available without a prescription, such as folic acid, contraception sponges, and spermicides, must be covered without co-sharing only when such products are prescribed by a healthcare provider. The [September 29 RFI] signals that the Departments are considering future rulemaking or new guidance that would eliminate the prescription requirement."  MORE >>

Miller & Chevalier

[Guidance Overview]

Minnesota Earned Sick and Safe Time (PDF)

12 presentation slides. "To be eligible, employees must work at least 80 hours in the state for the same employer ... Employers must provide at least 48 hours (one hour for every 30 hours worked) of ESST to covered employees each year. Employees can use accrued paid leave for illness/injury, domestic violence, closures, and health concerns related to communicable diseases."  MORE >>


[Guidance Overview]

Massachusetts PFML Update: Increased Contribution Rates and Weekly Benefit Amount for 2024

"Employers with a private or self-insured plan that has been approved by the DFML do not have to make PFML contributions to the Commonwealth. Such employers will need to adjust their private plan to reflect the new employee contribution rates and maximum benefit amounts.'

   MORE >>

Seyfarth Shaw LLP

[Guidance Overview]

California Expands Paid Sick Leave to Five Days or Forty Hours

"Beginning January 1, 2024, California employers must provide employees with five days or forty hours of paid sick leave. Employers still may limit annual use and accrual, although at a higher level than before. SB 616 also extends nonretaliation and procedural protections to collective bargaining agreement employees."  MORE >>

Ogletree Deakins

Participant May Receive Monetary Damages for Plan's Failure to Approve Procedure

"[T]he Court concluded that ERISA authorized the plaintiff to seek 'equitable relief.' It explained that while monetary relief awarded to compensate for a plaintiff's loss does not qualify as equitable, 'relief awarded under an unjust-enrichment theory may indeed qualify.' " [Rose v. PSA Airlines, Inc., No. 21-2207 (4th Cir. Sep. 11, 2023)]  MORE >>

The Wagner Law Group


Parity Means Better Coverage for Mental Health and Substance Use Disorders

"Despite the law's clear promise of parity between mental health and medical or surgical benefits, that promise has not been kept. People living with treatable mental health conditions commonly face red tape when seeking care, such as unexpected charges, strict preauthorization requirements and provider networks with far too few options available. This is wrong, it's illegal and it must stop.... [EBSA is] proposing new regulations, committing unprecedented resources to bringing plans into compliance with the law, and reaching out to communities across the United States to ensure that more of America's workers and families understand their rights and are better able to exercise them, including by contacting us for help when they need it."  MORE >>

Lisa M. Gomez, Assistant Secretary for Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]


Making the Promise of Value-Based Care Meaningful to Consumers

"[The authors share their] vision for how individuals, patients, and families can be best served by accountable care models that center on individual needs and preferences. Meaningful, equity-focused, value-based care is a promising and necessary alternative to fee-for-service medicine. [They] also call for action to increase provider uptake of value-based care models and engage patients and communities in their development, implementation, and evaluation."  MORE >>

Health Affairs Forefront

Benefits in General

[Guidance Overview]

Employer Student Loan Debt Benefits Following SECURE 2.0

"[This article] discusses the SECURE 2.0 student loan benefit and other employer options for providing tax-advantaged benefits to employees based on student loan payments. It also examines the open questions and current implementation challenges for sponsors of 401(k) and 403(b) plans hoping to implement the student loan benefit."  MORE >>

McDermott Will & Emery

Employee Benefits Jobs

View job as Compliance Consultant
            for Blue Chip Retirement Plans, Inc.

Compliance Consultant

Blue Chip Retirement Plans, Inc.


View job as Compliance Consultant for Blue Chip Retirement Plans, Inc.

View job as Senior Retirement Plan Consultant
            for Strongpoint Partners/Jocelyn Pension Consulting

Senior Retirement Plan Consultant

Strongpoint Partners/Jocelyn Pension Consulting


View job as Senior Retirement Plan Consultant for Strongpoint Partners/Jocelyn Pension Consulting

View job as Pension Administrator
            for Delaware Valley Retirement, Inc.

Pension Administrator

Delaware Valley Retirement, Inc.

Ridley Park PA / Hybrid

View job as Pension Administrator for Delaware Valley Retirement, Inc.

Press Releases

Ascensus Announces Spring 2024 Launch of Ascensus | American Funds PEP Solution


DOL Reaches Settlement with New York Insurer, Third-Party Health Plan Administrator to End 'Cross-Plan Offsetting' Practice

Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Webcasts and Conferences
(Health & Welfare Plans)

Sick Leave Is Here to Stay: A 10 Year 'If Pain, Yes Gain' Retrospective


Seyfarth Shaw LLP

Last Issue's Most Popular Items

2024 ACA Considerations for Employers


Gag Clause Attestation Due by December 31

Assured Partners

The ACA Monthly Measurement Method


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BenefitsLink® Retirement Plans Newsletter, ISSN no. 1536-9587.

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